I 116TH CONGRESS 1ST SESSION H. R. 3654 To amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians’ services furnished by doctors of chiropractic within the scope of their license, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JULY 9, 2019 Mr. HIGGINS of New York (for himself and Mr. REED) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce, and in addition to the Committee on Ways and Means, for a pe- riod to be subsequently determined by the Speaker, in each case for con- sideration of such provisions as fall within the jurisdiction of the com- mittee concerned A BILL To amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians’ services furnished by doctors of chiropractic within the scope of their li- cense, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Chiropractic Medicare 4 Coverage Modernization Act of 2019’’. 5 VerDate Sep 11 2014 22:59 Jul 16, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3654.IH H3654 kjohnson on DSK79L0C42 with BILLS 2 •HR 3654 IH SEC. 2. FINDINGS; STATEMENT OF PURPOSE. 1 (a) FINDINGS.—Congress finds the following: 2 (1) In 1972, coverage was established under the 3 Medicare program for beneficiaries to receive chiro- 4 practic care. 5 (2) Unfortunately, the antiquated statute re- 6 stricts beneficiaries to one service in a chiropractic 7 clinic and Medicare chiropractic coverage has not 8 kept up with private sector coverage and other fed- 9 eral health delivery systems. 10 (3) Today, due to positive evidence-based out- 11 comes and cost effectiveness of the services provided 12 by doctors of chiropractic, private coverage for chiro- 13 practic services has evolved and State licensure for 14 chiropractors has advanced to meet patient needs 15 and health outcomes. 16 (4) This Act would bring Medicare chiropractic 17 coverage more in line with that provided with the 18 Department of Veterans Affairs, Department of De- 19 fense, the Federal Employee Health Benefits Pro- 20 gram, and private health insurance coverage. 21 (b) PURPOSE.—It is the purpose of this Act to ex- 22 pand recognition and coverage of a doctor of chiropractic 23 as a ‘‘physician’’ under the Medicare program in connec- 24 tion with the performance of any function or action, in- 25 cluding current service of ‘‘manual manipulation of the 26 VerDate Sep 11 2014 22:59 Jul 16, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3654.IH H3654 kjohnson on DSK79L0C42 with BILLS 3 •HR 3654 IH spine to correct a subluxation’’, as is legally authorized 1 by the State in which such doctor performs such function 2 or action. 3 SEC. 3. PROVIDING MEDICARE COVERAGE FOR ALL PHYSI- 4 CIANS’ SERVICES FURNISHED BY DOCTORS 5 OF CHIROPRACTIC WITHIN THE SCOPE OF 6 THEIR LICENSE. 7 (a) IN GENERAL.—Section 1861(r)(5) of the Social 8 Security Act (42 U.S.C. 1395x(r)(5)) is amended by strik- 9 ing ‘‘a chiropractor who is licensed as such by the State 10 (or in a State which does not license chiropractors as such, 11 is legally authorized to perform the services of a chiro- 12 practor in the jurisdiction in which he performs such serv- 13 ices), and who meets uniform minimum standards promul- 14 gated by the Secretary, but only for the purpose of sec- 15 tions 1861(s)(1) and 1861(s)(2)(A) and only with respect 16 to treatment by means of manual manipulation of the 17 spine (to correct a subluxation) which he is legally author- 18 ized to perform by the State or jurisdiction in which such 19 treatment is provided’’ and inserting ‘‘a doctor of chiro- 20 practic who is licensed as a doctor of chiropractic or a 21 chiropractor by the State in which the function or action 22 is performed and whose license provides legal authoriza- 23 tion to perform such function or action in such State or 24 VerDate Sep 11 2014 22:59 Jul 16, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3654.IH H3654 kjohnson on DSK79L0C42 with BILLS 4 •HR 3654 IH in the jurisdiction in which the function or action is per- 1 formed’’. 2 (b) CERTAIN COVERAGE LIMITS.—Section 1833 of 3 the Social Security Act is amended by adding at the end 4 the following new subsection: 5 ‘‘(cc) LIMITATION ON PAYMENT OF SERVICES PRO- 6 VIDED BY CERTAIN DOCTORS OF CHIROPRACTIC.—Not- 7 withstanding any other provision of this part, in the case 8 of services of a doctor of chiropractic described in section 9 1861(r)(5), payment may only be made under this part 10 for such services if— 11 ‘‘(1) such services are furnished by a doctor of 12 chiropractic who is verified once, by a process de- 13 signed by the Secretary, as attending an educational 14 documentation webinar, or other similar electronic 15 product, designed by the Secretary or an updated 16 modified version of such webinar, as designed by the 17 Secretary; or 18 ‘‘(2) such services are treatment by means of 19 manual manipulation of the spine to correct a sub- 20 luxation.’’. 21 Æ VerDate Sep 11 2014 22:59 Jul 16, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H3654.IH H3654 kjohnson on DSK79L0C42 with BILLS